Birkhäuser M H, Huber P R, Neuenschwander E, Näpflin S
Universitäts-Frauenklinik Basel.
Geburtshilfe Frauenheilkd. 1988 Apr;48(4):220-7. doi: 10.1055/s-2008-1026491.
The Polycystic Ovary Syndrome (PCO) is characterised by an elevated ratio of serum LH to FSH in presence of an intrafollicular deficiency of FSH activity. Ovulation induction by "pure" FSH seems therefore a reasonable approach to longstanding chronic anovulation in infertile patients suffering from PCO. 68 treatment cycles have been conducted in 30 patients with PCO and chronic clomiphene-resistant anovulation. Ovulation has been induced by HCG in 57 of the 68 cycles. The pregnancy rate was 58.6% per patient, the success rate 46.7% per patient. Clinical abortions occurred in 17.6% of the pregnancies obtained. 3 twins and 2 triplets have been delivered at term. A hyperstimulation syndrome (HSS) of grade I (WHO) has been observed in 19.1%, a HSS of grade II (WHO) in 8.8% of the treatment cycles. 46.3% of the 54 analysed cycles presented a premature LH-surge leading to an atresia of the dominant follicle. Considering the high incidence of a premature elevation of endogenous LH, an additional administration of exogenous LH should be avoided. This consideration as well as the good success rate in the present series speak in favour of using "pure" FSH for induction of follicular maturation in clomiphene-resistant PCO.
多囊卵巢综合征（PCO）的特征是在卵泡内FSH活性缺乏的情况下，血清LH与FSH的比值升高。因此，对于患有PCO的不育患者长期慢性无排卵，使用“纯”FSH诱导排卵似乎是一种合理的方法。对30例患有PCO和氯米芬抵抗性慢性无排卵的患者进行了68个治疗周期。68个周期中有57个周期通过HCG诱导排卵。每位患者的妊娠率为58.6%，成功率为46.7%。在获得的妊娠中，17.6%发生了临床流产。足月分娩了3例双胞胎和2例三胞胎。在19.1%的治疗周期中观察到I级（WHO）的卵巢过度刺激综合征（HSS），在8.8%的治疗周期中观察到II级（WHO）的HSS。在54个分析周期中，46.3%出现了过早的LH峰，导致优势卵泡闭锁。考虑到内源性LH过早升高的发生率较高，应避免额外给予外源性LH。这一考虑以及本系列中的良好成功率支持使用“纯”FSH诱导氯米芬抵抗性PCO患者的卵泡成熟。
